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Anterior Cranio-Cervical Approach: Transnasal

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Spinal Tumor Surgery

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Abstract

Anterior and anterolateral cranio-cervical lesions present challenging operative cases given their proximity to vital neurovascular structures. Several pathologies can affect the cranio-cervical junction (CCJ) including neoplasms, rheumatologic disease, fibroconnective tissue disease, congenital disease, infections, and traumatic and degenerative disorders. Numerous approaches have been employed to gain access to this region, including the transcervical, transnasal, transoral, and variations of the far-lateral approach. The transnasal approach for the cranio-cervical region provides an alternative approach that allows for good visualization of the CCJ while limiting the number of complications. The use of endoscopy for the transnasal approach provides a panoramic view that can provide improved lighting and resolution compared to the operative microscope. It also provides direct access to the anterior and anterolateral CCJ without needing to mobilize the surrounding neurovasculature. This chapter describes the transnasal surgical approach to the anterior cranio-cervical junction.

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Author information

Authors and Affiliations

  1. Johns Hopkins Hospital, Department of Neurosurgery, Baltimore, MD, USA

    Chikezie I. Eseonu

  2. Johns Hopkins University, Department of Neurosurgery, Baltimore, MD, USA

    Gary Gallia

  3. Johns Hopkins University, Department of Otolaryngology, Baltimore, MD, USA

    Masaru Ishii

Authors
  1. Chikezie I. Eseonu
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  2. Gary Gallia
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  3. Masaru Ishii
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Corresponding author

Correspondence to Chikezie I. Eseonu .

Editor information

Editors and Affiliations

  1. Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA

    Daniel M. Sciubba

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Eseonu, C.I., Gallia, G., Ishii, M. (2019). Anterior Cranio-Cervical Approach: Transnasal. In: Sciubba, D. (eds) Spinal Tumor Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-98422-3_1

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  • DOI: https://doi.org/10.1007/978-3-319-98422-3_1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-98421-6

  • Online ISBN: 978-3-319-98422-3

  • eBook Packages: MedicineMedicine (R0)

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